Wednesday, March 4, 2009

The Tuskegee Incident

The Tuskegee Incident changed the face of research. Institutional Review Boards were estabished based on the terribly unethical results of this "study". The four links below provide several different websites that address this terrible incident. Click below and comment.

36 comments:

I think that this experiment was an enormous tragedy that has not began to be rectified by the parties that are responsible for the horrific acts. I understand the need for the Institutional Review Board (IRB) and applaud the whistle blower that informed the public of what had been going on for the last 40 years. I also see why the NASW formed the Code of Ethics for our profession, it seems to set us apart from all other professions. I must admit that I did not know that the Tuskegee Institute had a culptable role in hiding this atrocity. I can not believe that other African Americans would subject these men to this cruel and unusual punishment that was disguised as an educational/training opportunity. I can't believe that anyone no matter the color, creed, sexuality, gender, and etc. would subject anyone else to this type of treat. I live by the principle that says "do unto others as you would have them to do unto yoi". I wouldn't want me, my family, friends, neighbors, or even my worst enemy treated this way. I do have some questions, besides paying for their health benefits, what happened to the numerous individuals that committed this act of social injustice. Does the IRB have consequences set aside for researchers that violate their standards? The punishment for the government seemed like a slap on the wrist in my opinion. Why was the nurses and the head of the PHC the only names that were published in these articles? These articles have shown me the ethical dilemmas that can occur when doing research. Is it okay to treat human beings this way if it helps to save the lives of others? Does the ends justify the means? Should the researchers and the others that were actively involved have faced prosecution for their crime againist humanity? These are all questions that I do not have to hesitate to answer, but I don't know what I would have done if I were that nurse back in 1932. Would I have gone along with it or sacrificed my job, my home, my income, and ultimately my family for some people that I didn't even know. Does good truly triumph or evil or is good just a relative term that changes as situations changes? I guess I ended up with more questions than answers.I must admit these articles have really stirred up my social justice side and I am truly appalled by what took place from 1932-1972. I would hope that time and tougher restrictions would help to ensure the safety of human subjects now and not let them be treated as animals. Even animals deserve to be treated better than this. I have one question to ask of those who read this blog, do you still think that this is going on in the present time?

The ethical principles of the NASW Code of Ethics include service, social justice, self worth and dignity, value of human relationships, integrity, and competence. These are all values that should be considered and applied when working with any service profession. Unfortunately, researchers did not believe the participants in the Tuskegee Incident deserved such values.

I noticed several “incidents” that violates the ethics code that social workers abide by. Such as the fact that these men and their families were not informed of the study at all; there was not an informed consent to give them the choice of participating. The “true” meaning and consequences of the study were never disclosed to them. They were told blatant lies including that they were being treated for “bad blood”, while the doctors had no intentions of treating or curing them. Though a cure had been discovered they were not treated. They were also misled, due to their illiteracy (I believe), to receive a “dangerous spinal tap”. Physicians throughout their community denied them treatment, and this was carried out for more than 30 years. These are just a few of the ethical concerns that I became aware of while reading the web pages.

Was the study really about diminishing the black race? This study did not only affect the direct participants, but their families as well. They passed syphilis to their wives who passed it to their infants. The men received certificates of appreciation from “the Surgeon General” for participating in the study for 25 years, knowing that they were participants until they died. While the government held a major role, consider the Tuskegee doctor who believed it was an “opportunity” for interns’ and nurses’ education. Is it not unethical to use human beings as “lab rats” to further science? What about Nurse Rivers or Miss Evers? They trusted her. Though she wanted to consider their best interest first, she acted accordingly to following “the doctor’s instructions”. Fortunately, there is now “duty to warn” to assist those who are in such situations to maintain the well-being of others.

Were these men lives and the lives of their families worth free medical exams, free meals, and burial insurance? No, they should have been allowed the opportunity to choose whether they wanted to participate, knowing all of the procedures, consequences, and other pertinent information regarding the study. Unfortunately, they were never given that choice. According to Borgna Brunner, “Since the men had in fact received some medication for syphilis in the beginning of the study, however inadequate, it thereby corrupted the outcome of a study of “untreated syphilis”. (http://www.infoplease.com/spot/bhmtuskegee1.html)

The Tuskegee Incident is a horrific example of human exploitation. It is unbelievable that this study went on for forty years before someone finally spoke out about the inhumane treatment of the Tuskegee men. Looking at this from a social worker’s perspective, this study definitely violated the social work principle of respecting the dignity and worth of the person. The human value of these men was based on their low economic and educational status. Because the government viewed these men as unworthy and easy to manipulate, they became the targets of this heinous study. While the Tuskegee Syphilis Study was being conducted, laws were being passed that would have helped protect these men, laws like the Henderson Act of 1943, a public health law requiring testing and treatment of venereal disease, and the Declaration of Helsinki (1964), which made “informed consent” a requirement of all experiments involving human subjects. As these laws were passed, the government made sure that the men of Tuskegee would not benefit from the new laws. It was stated that the study was meant to compare the affects of syphilis on “blacks” verses “whites”; however, there is no mention of white men participating in the study. Were white men being denied medical treatment in order to gauge the effects of syphilis on them? How was the government making this comparison without having a white group of men being untreated for syphilis? The suffering that the Tuskegee men endured prompted the establishment of the National Research Act in 1974. Under this law, any research study that involves human subjects must be reviewed by an IRB. Even if the results of the Tuskegee Syphilis Study provided little for syphilis treatment, the men of this study can be honored as change makers. Because of these men, human beings will be protected from those who wish to harm others in the name of “science.”

The Tuskegee Syphilis Study violated several laws and regulations set forth to protect individuals from harm. When the study began there were no specific guidelines as to how to conduct a study. By allowing this study to go on for forty years, this has become one of the most unethical and inhumane events in the United States. Today there are many more laws and steps to take in order to conduct a study with human subjects. The Tuskegee Syphilis Study was extremely unethical and should have been put to a stop much earlier in the process. It is unimaginable that so many organizations could come together and treat several individuals so horribly that in the end many lost their lives. A human service worker has a responsibility to treat their clients with respect and dignity as well as looking out for their safety (NOHS, 2005). A human service worker has an obligation to avoid any type of treatment or experiment that would put the client in harm's way. Several major ethical issues involving human research subjects need to be studied further. The first major ethical issue to be considered is informed consent, which refers to telling potential research participants about all aspects of the research that might reasonably influence their decision to participate. A major unresolved concern is exactly how far researchers’ obligations extend to research subjects. Another concern has to do with the possibility that a person might feel pressured to agree or might not understand precisely what he or she is agreeing to. The investigators took advantage of a deprived socioeconomic situation in which the participants had experienced low levels of care. The contacts were with doctors and nurses who were seen as authority figures. The second major ethical issue is the withholding of treatment for research purposes. This is the gravest charge against the study. Patient welfare was consistently overlooked, although there have been multiple attempts to justify why penicillin treatment was withheld.

There were so many issues with this “study”. This “study” is, however a great example of how not to conduct a study. This “study” gives new meaning to lack of informed consent. One issue I had was that I did not comprehend was why only blacks were chosen for the “study”. In the article entitled, “The Tuskegee Syphilis Experiment”, it states that the intention of the “study” was to determine how syphilis affected both blacks and whites, with the assumption being that blacks were more prone to cardiovascular problems and whites were more prone to neurological problems. I do not understand why both blacks and whites were not studied, if this was what was trying to be discovered.Another thing that I would like to point out is that the participants received free examinations, free meals, and free burial insurance. I believe that the burial insurance was how the doctors were able to perform autopsies in order to collect their data without the family being fully aware of the doctor’s intentions.

The Tuskegee Incident violated the ethical principles and the rights of the participants. These men were not given the opportunity to give informed consent. They were lured under the false pretense of acquiring free medical care. They were not told of the harmful effects including death that might occur as a result of their participation in the study. Not only were their rights violated, the men were dehumanized for the sake of research. It is appalling to think anyone would allow people to suffer and receive funding as a result. Those invested in the study, including the government, went through great lengths to prevent participants from obtaining treatment. The fact the CDC initially approved the study floored me because the agency’s purpose is to promote disease control. From the readings, we learned the ramifications of the study went far beyond the participants as 40 spouses and 19 offspring were affected by the disease. I am glad the Institutional Review Board was developed to prevent the maltreatment of subjects. However, the implementation of the IRB can not erase the effects on the participants and the African American community. Growing up, I heard stories of the government introducing drugs into the black community to wipe out the race. I have also heard AIDS was introduced for the same reason. There is a lack of trust toward the government,physicians regardless of race, officers regardless of race, etc., in the black community. I am not suggesting this study is the only reason or a major reason for the distrust among African Americans, I am merely suggesting that it may have played a small role.

Original Post by: Brent EubanksAfter reviewing the various articles on the "Tuskegee Incidnet", I found that this is another example of social injustice that the African American community faced prior to the Civil Rights Movement. It seems that basically the black men that participated in this study were treated as nothing more than laboratory mice. As the article provided by the CDC stated, the men were even denied the proper treatment available at the time of the so-called "experiment" and that those that participated in the study were not even given a choice of quitting, even when the proper treatment was made available. Although the experiment was deemed as "ethically unjustified", I feel that this experiment was almost criminal in nature. These men suffered long term health effects from the disease and many died as a result of the study. I find it very interesting that the PHS did not agree with the comparison made between themselves and the Nazi doctors that performed experiements on Jewish victims during WWII, when they were basically guilty of the same practices. I guess that we can be thankful for entities such as the IRB because with their oversight, this type of tragedy should never happen again.

Response to Original Post by Carrie Wells:I think that you make an excellent point in stating that this "experiment" violated the social work principle of maintaining the dignity and worth of a person. I guess that to those in charge of implementing the study, just because these men were 1) black and 2) of a lower socio-economic status that they felt somewhat justified in their treatment of these individuals. After the experiment began, these men did not have any dignity left. And to think that after all of the suffering that these men went through, all they received was life-time health benefits and money.How noble of our government. Human lives are worth more than money and all the benefits in the world.Posted by: Brent Eubanks

You make an excellent point in posing the question "is it okay to treat human beings this way if it saves the lives of others?" I don't know the answer to that question, but my gut tells me that the answer would be NO. Like yourself, I would not want my family or friends treated this way and that is what I thought of when reading the articles: these were fathers, uncles, brothers, etc. In an answer to your final question as to whether or not this is happening today or not, I would like to think that as Americans we have hopefully learned from our mistakes, but I am suprised daily at what people are capable of doing.Posted by: Brent Eubanks

The Tuskegee Syphilis Experiment was horrific and cruel;this experiment did not enhance human well-being nor did it enhance social justice or social change; this experiment promoted social injustice.The men in the experiment were used as laboratory animals; from reading the articles the experiment was supposed to discover how syphllis affected blacks opposed to whites. The only thing was the white men were treated for their symptoms of syphilis and the black men were not. I was outraged at how the true nature of the experiment was kept from the black men. I was also upset that this went on for forty years by the U.S. Public Health Service. It appears that these men were never acutally told what they were suffering from; I think that was unethical and the people conducting the experiment had no regards to the importance of human relationships and integrity. As a socia worker, I think that all the ethical principles were violated service, social justice, dignity and worth of the person, the importance of human relationships, integrity, and competence. I feel that this experiment is one of the reasons why we have Institutional Review Boards; they are the 'WATCHDOGS".The Tuskegee Incident led to the 1974 National Research Act beig passed; which requires any organziaton involved in the conduct of biomedical or behavioral research involving human subjects to establish an IRB board.I know that evidence-based research is important,but there have to be some standards and guidelines when conducting studies. I have heard about this incident for years; it is just a case of a devestating trajedy in the name of science; by the end of the experiment, 28 of the men had died directly of syphilis, 100 of their wives had been infected, and 19 of their children had been born with complicatons. This experiment not only affected the lives of the men involved,but it made a negative impact on their families as well.

Response to JLindsey -Tameka L. AskewI agree with you 100%; this STUDY, is a excellent example of what not to do in a case study. I think that the study was very one-sided and did not prove anything; it proved that if a person does not get treated for syphilis, there are detrimental consequences. The doctors were very underhanded and misled so many people and their families, this is a social injustice in itself.

In reading about the Tuskegee Syphilis Study, it is evident why institutional review boards are needed. Several ethical violations took place during the project that hopefully would not occur today since there is now closer oversight of research studies. The participants were lured into participating in the study by being promised a free medical examination, free transportation, and food. During that time there were concerns about “bad blood” and most of the participants did not have access to medical care prior to this offer. Due to the rumored concerns about “bad blood” many agreed to accept the free health screenings. Upon their participation in the study, they were unknowingly then infected with syphilis. They were then given little to no treatment for their conditions and the U.S. Public Health Service was told to deny treating any of the participants who came seeking help. The ethical violations were that the participants were not informed of the truth about the study, they were harmed through the study, and then they were refused treatment for the disease.

I would certainly hope that research such as this is not still happening today. However, if working with vulnerable clients I can see where it could still happen, even today. Information that is gathered is to be turned into the IRBs and I am sure that there are times when it is "altered" in order to gain the desired outcome. Let's hope this does not happen very often though...but I am with you and wonder if there are still instances such as this. Hopefully the oversight and supervision is close and unethical practices are at least very limited.

The Tuskegee Syphilis Experiment is just almost unbelievable. I really can't imagine anyone thinking that it would be alright to treat any human being the way these individuals were treated. They were treated as if they were animals and not humans. They had no rights whatsoever. They were not even told what was going on, they were only given what they thought was free medical care for a blood disorder, free meals and a burial policy. What amazes me is that it went on for 40 years before someone realized how unethical it was. I know that the IRB board makes researchers go through hoops in order to have their particular research approved but when you read about the complete unethical experiment such as this one you understand why that board is so important. Without the board's regulation then mistreatment of subjects would probably occur, maybe not to such extreme, but it would happen.

Response to ILOVEKIDS. I am not even sure horrific and cruel even describes how unethical this experiment was. You made a comment at the end of your post that this experiment not only affected the lives of men involved, but it made a negative impact on their familes as well. I can not imagine how these families felt or still feel about what happened to their family member. It would be very difficult to forgive someone for such a horrible injustice.

The Tuskegee Incident went against all ethical principles we hold as social worker's. The men who were a part of this experiment were being mistreated and were uninformed. Not only were the men affected, but their wifes and children as well, as the disease spread due to lack of treatment. As social workers we are to value service, social justice, dignity and worth of a person, importance of human relationships, integrity, and competence. The doctors and nurses were doing a disservice to these men and were taking advantage of them because they had no from of insurance and had little income. The men in the experiment were not respected and as it has been said before were treated like animals. Fortunately, regulations for conducting an experiment have changed and individuals must give informed consent when choosing to participate. Even though they may not know which group, experiment or control, they may be in they are aware of what they are signing up for. These men of Macon County had no clue and were fully taken advantage of.

Research has its place in Social Work, but it is not the goal of Social Work. Through the Tuskegee Experiment, research became more important than human life. The “Tuskegee Syphilis Experiment” clearly violates the ethical principles outlined in the NASW code of ethics which are as follows: service, social justice, dignity and worth of the person, importance of human relationships, integrity, and competence. The research experience could have easily appeared to the subjects to be reaching out in service, fighting for social justice, showing concern for the subjects and their relationship, practicing integrity and performing competently. The free medical service and treatment for their “bad blood” may have appeared to be service but was sadly the opposite. This experiment socially oppressed people rather than fighting for social justice. It was corrupt, lacking integrity. The participants were blatantly lied to at times. The study didn’t value human life or human relationships. The fact that the study lasted for 40 years is an indicator that it was run without competence.

What should have been done differently?

When I begin to think about what should have been done differently in the study, my first thought is that it should have never been done at all. If the Public Health Service wanted to find out information about people with syphilis after their death, they should have created an informed consent agreeing to release information about their autopsies after death.

If the experiment was performed, an informed consent should have been used and the researchers should have been honest with the participants about what services they were receiving. The doctors also should have had more interest in the patients than the results. Science was elevated above the value of human life, which is not acceptable among social workers. The doctors performing the research viewed the participants as data, rather than human. This aspect is something that if approached differently would have altered the entire experiment. If the doctors cared about the patients, they would have been honest with them about the intent of the experiment.

If the doctors would have been honest, I don’t believe that the experiment would have ever taken place. If the participants truly understood, what was going on they most likely would have refused to be a part of the study, especially when penicillin was discovered to be a cure.

I also wonder about what happened to the others involved in this study. Ms. Arnold pointed out that only a few people were named, but this study was large enough to have required many personnel. Add to the fact that it lasted for four decades, there were obviously many individuals involved. As an example, when the HealthSouth investigation was going on in the state of Alabama, investigations were conducted from Richard Scrushy to accounting clerks. I believe that this kind of scrutiny needed to occur in the Tuskegee Incident.

Ms. Ford wrote, "However, the implementation of the IRB can not erase the effects on the participants and the African American community."

I wholeheartedly agree to this statement. A class-action lawsuit was filed by survivors of the Tuskegee Incident. Their final payments were $40,000 for the egregious treatment they endured. What a sad pittance of compensation. This award was not provided until 1992. Even President Clinton's national apology to survivors on behalf of the government was not enough. By the time the apology was delivered - 1997 - only a few survivors remained. Both efforts were too little too late.

There were multiple ethical violations during this “study”. Shija’s statement, “the investigators took advantage of a deprived socioeconomic situation” made me think of something I read in one of the articles. The article suggested racism. Was this why the participants received low levels of care, because they were African American, because they were illiterate? All participants of research should receive informed consent regardless of their cultural background. Otherwise it violates, both professional and personal, ethical values. I am very thankful for IRBs; they are conducive to research abiding the code of ethics.

Hey Melinda,I read your post and agree that the participants should have been told about the true nature of the experiment and that they should have signed consents to be used in this study. I think that there is one reason that these researchers and their many cohorts did not tell the truth and did not offer any consents for this study and it is because no one would have agreed to take part in this study. What person that is afflicted with a disease would consent to recieving no treatment so that the researchers could jugde how long it would take them to die from it? None that I can think of. I agree with you that they looked at the participants as sources of data instead of human beings and that is the biggest crime that was committed. This crime is a crime against humanity, not just againist a specific race. In my opinion, these researchers had no regard for the sanctity of human life, so why would they practice any ethics and values at all if they can not even value human life in the truest sense of the word. In order to treat someone ethically then you must first acutally envision them as being humans. As social workers, I think that we are offended by this type of act. These researchers were doctors and not social workers and we all know that they practice from the medical model instead of from the biopsychosocial model. I think that this fact should be weighed heavy in this conversation. As doctors they just want to cure symptoms, they don't care how it affects the person, their family, this society, or the world.

I agree with you, after reading about this study I see exactly why the Institutional Review Board is vital to conducting research. Like you, I questioned if there were any consequences for the actions of the doctors and nurses. I personally would not be surprised if these types of studies are still being conducted today, just not made known to the public. People in positions of authority are aware of who they can take advantage of. It is always the poor and underprivileged who suffer.

I do not really know where to start with this post. I have looked at what others wrote and am in total agreement with what most of everyone said. This was horrible, tragic, incomprehensible, awful, and any other word you could use to describe an injustice like this one. It is something that makes me ashamed in a way to live in a place that such atrocities were allowed to take place. There was no real science associated with this incident and there was no real reason for these men to be submitted to such treatment other than the color of their skin and their socioecomonic status. To think that we still have to discuss things like this today to prove that racism, oppression, and social injustice exists is ridiculous to me. The scary thing for me is that people seem to overlook injustices and say "oh that's just the way it is". Well, I for one am tired of that being "just the way it is" here, and want to show people that things can be different. Just today I had a conversation with an African-American female about some of her experiences growing up in Alabama and even as little as 5 years ago, she was discriminated against in such a way that she now has a real fear of police. Though this has nothing to do with IRBs or research, I think it is valid for this discussion. IRBs are important to prevent this type of treatment in the scientific/research word, but what is going to prevent it from the "everyday" world. I am proud to be a Social Work student and hope to continue making a difference in the lives of others and in overcoming oppression and racism.

Many of us are upset, and many of us are saying this should not have taken place, there should have been imformed consent, or many other issues related to ethics. I completely agree with all of those, but I think that the true deep rooted issue is race and how people viewed African-American citizens at that time. Again, there was no mention of Caucasian men being treated or not treated in the article. Who knows if there was ever anyone else involved in this study. For anyone to look at this incident and say race was not a factor, I feel is a complete slap in the face to those who were basically murdered by our government.

The "Tuskegee Syphilis Experiment" is very in humane. It demonstrated how little respect there was for the 399 black men that suffered from this disease. The sad thing about this is that it was in the late stages and they were not told what they were been treated for. The doctor stated that he had no interest in these patients until they die. To be a doctor his licenses should have been revoked on the spot. I'm glad that the Institutional Review Board is set in place to establish ground rules on how research should be conducted. There were many ethical issuses principals broken toward these men. Another thing is why does it has to always be African Americans that get the bad in? I really hate that it has to be a race issue but it is what it is. I am thankful that the Civil Rights moment took place. It still does not justifiy how these men was treated. At the end of the experiment 28 men died directly from syphillis,100 died from related complications, 40 of their wives was infected and 19 of their children was born with congential syphillis. How much money could possible replace how these families were violated.

Knowledge of the Tuskegee Experiment coming to light plays a huge part in African Americans not trusting the government and or European Americans. The “experiment” violated several ethical standards coming from a social work perspective. For starters, the experiment was conducted on illiterate sharecroppers who lacked the ability to comprehend what was happening to them even if informed consent was obtained, which it was not. The sharecroppers were denied self-determination as to opt out of the experiment. I am not aware of any social workers being involved in the experiment. There was a conflict of interest on the part of the federal government by way of the surgeon general. Part of the surgeon general’s role is to improve the public’s health not to turn a blind eye to such a human travesty. All of this aside, I have more questions than answers. I am concerned about the people that were affected that were not families of the participants. I would like to know the background as to how Macon County, Alabama was chosen for the experiment. I am having trouble understanding how so many blacks could not have a glimpse of something being “amiss” even if they could not tell what it was exactly. Why is it that the interviewer came forward when he did? As for the nurse, she would be considered part of the “Willie Lynch Theory” that I learned about from a friend. The Willie Lynch Theory is believed to have been created to undermine the trust between African Americans to keep them from coming together to defeat slavery, thus discrimination. I can see how the lack of trust in some African Americans in certain positions continues until this day, all in the name of providing an “opportunity” for a select few. Today, I wonder how many African Americans are in a position such as Nurse Eunice Rivers. It is much easier now to be critical; I do not know what I would have done, during that time, if I was faced with the same. Clearly, there was no one to stand up for the sharecroppers even after the passing of the Henderson Act of 1943 and the Declaration of Helenski in 1964. Malinda S.

Response to ShijiI am amazed that the study continued for so long. One of the comments from the U.S. Public Health Service (PHS) was that the media was making a mountain out of a mole hill. What was the PHS thinking when they made that comment? Was it that it was only “darkies” involved and that their lives were insignificant. Malinda S.

Response to Carrie WellsI say this exploitation of humans is a perfect example as to why social workers are needed to combat issues such as the Tuskegee Institute Experiment. Social workers are taught by trade and most possess an innate passion to respect the dignity and worth of a person, regardless of their economic and educational background and status. Malinda S.

I also agree this study is an excellent example of how not to conduct a study. It violated so many things it is hard to know where to begin. I did wonder why white males were not included in the study as well. I am glad they were not because it would mean more suffering. But I totally get your point....

Many of us do not comprehend how someone could justify treating people this way. It makes me think of deficiency theory that we studied in HBSE II. It seems that this theory could give some explanation as to why. Somewhere someone communicated to the researchers that the participants had something wrong with them. Granted this doesn’t excuse it or justify it, but just a possibility of the why behind it.

In my opinion, words can no even begin to describe the injustice that the participants in The Tuskegee Incident endured. No research is important enough to subject human being to such things. Luckily, we have the NASW Code of Ethics which clearly speaks against Social Workers performing any type of research in this manner. Furthermore, I would hope that any individual who obtains a degree in Social Work would not be interested in unethical research to the degree of actually harming humans regardless of their race, religion, social status, gender, sexual orientation, etc.

Through the years I have heard that some African Americans fear that our government was in some way responsible for the AIDS epidemic. I have never directly spoken with someone who agrees with this theory. Therefore, I am not familiar with the details of the theory but after learning of The Tuskegee Incident I can see why someone, well, anyone would be suspicious of and fearful of our government. The government was aware of these actions and did nothing to protect the participants. Based on the history of our country and the discrimination that African Americans endure I can see how the injustice would occur years ago. But the fact that the victims did not get a formal apology from the government until President Clinton’s apology during his term in office is just ridiculous to me.

I completely agree with your perspective on how horrific this situation was. It appalled me as well. I think you have some very logical and meaningful questions. These articles raised questions for me too. The articles even make me question our government as it is today. I realize that the government performs a lot research that we will never know about and a lot of it that we would probably not agree with ethically. However, there is a limit and I not only professional but also personally believe that every human life is invaluable. Unless an individual is fully aware of all of the details within a specific study that they are participating in they should not be subject to it even if the research may safe another life in the future.

I agree I could not say what I would have done in those times also. The sharecroppers thought they would have a prosperous, successful, and healthy life with all the things they were offered as compensation for the study. They were illiterate and did not know any better that what they were approached with. I wonder if social workers were helping with study if things would have been different.

I agree we now know what “research gone bad” is. It makes you think how so many things could be done so wrong in one study. I think the best lesson learned from the study is what not to do when you are conducting research and also what things need to be done correctly when conducting research.

Thankfully many actions have been taken in an effort to prevent any type of incident like this from ever happening again. The Institutional Review Board is one of them. We as social workers also have the NASW Code of Ethics to follow. We can only do our part and hope others are not being victimized, however, like Julie said people are being taken advantage of every day and don't even know it.

The first couple of times I read the NASW code of Ethics I was stunned. My initial reaction was, “Duh…do they really have to tell adult professionals to operate with such rational standards?” Episodes like the Tuskegee Incident are history’s reminder even adult helping professionals are capable of harming other human beings. There are many instances in social work where simple answers are not available to resolve complex ethical issues. I think it’s great that the profession has decided to enforce standards like integrity, self determination, and informed consent. These standards provide a universal frame of reference for practitioners and outline expectations of behavior. Ethics, along with the establishment of Institutional Review Boards (IRBs), are designed to protect people from harmful, risky, and/or unethical research and practice. While the Code of Ethics and IRBs cannot guarantee ethical behavior, both are designed to prevent the likelihood humans being subject to cruelties like those that occurred in the Tuskegee Incident.